Brief Article
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World J Gastroenterol. Mar 28, 2014; 20(12): 3320-3326
Published online Mar 28, 2014. doi: 10.3748/wjg.v20.i12.3320
Protective effects of intravenous anesthetics on kidney tissue in obstructive jaundice
Sinan Hatipoglu, Huseyin Yildiz, Ertan Bulbuloglu, Ismail Coskuner, Ergul Belge Kurutas, Filiz Hatipoglu, Harun Ciralik, Mehmet Sait Berhuni
Sinan Hatipoglu, Department of General Surgery Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey
Huseyin Yildiz, Ismail Coskuner, Department of Anesthesiology and Reanimation Unit, School of Medicine, Kahramanmaras Sutcuimam University, 46100 Kahramanmaras, Turkey
Ertan Bulbuloglu, Mehmet Sait Berhuni, Department of General Surgery Unit, School of Medicine, Kahramanmaras Sutcuimam University, 46100 Kahramanmaras, Turkey
Ergul Belge Kurutas, Department of Biochemistry Unit, School of Medicine, Kahramanmaras Sutcuimam University, 46100 Kahramanmaras, Turkey
Filiz Hatipoglu, Department of Obstetrics and Gynecology Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey
Harun Ciralik, Department of Pathology Unit, School of Medicine, Kahramanmaras Sutcuimam University, 46100 Kahramanmaras, Turkey
Author contributions: Hatipoglu S and Yildiz H contributed equally to this work; Hatipoglu S, Yildiz H and Bulbuloglu E designed the research; Hatipoglu S, Yildiz H and Bulbuloglu E performed the research; Hatipoglu S, Yildiz H, Bulbuloglu E, Coskuner I, Kurutas EB, Ciralik H, Hatipoglu F and Berhuni MS contributed new reagents/analytic tools; Hatipoglu S, Yildiz H and Bulbuloglu E analyzed the data; Hatipoglu S wrote the paper.
Correspondence to: Sinan Hatipoglu, MD, Assistant Professor, Department of General Surgery Unit, School of Medicine, Adiyaman University, Altınsehir Street, 02040 Adiyaman, Turkey. hamitsinanh@gmail.com
Telephone: +90-505-4509402 Fax: +90-416-2231693
Received: November 11, 2013
Revised: January 14, 2014
Accepted: January 19, 2014
Published online: March 28, 2014
Processing time: 134 Days and 5.3 Hours
Abstract

AIM: To evaluate the protective effects on kidney tissue of frequently used intravenous anesthetics (ketamine, propofol, thiopental, and fentanyl) in rats with obstructive jaundice.

METHODS: There is an increased incidence of postoperative acute renal failure in patients with obstructive jaundice. Thirty-two Wistar-albino rats were randomly divided into four equal groups. Laparatomy was performed on each animal in the four groups and common bile ducts were ligated and severed on day 0. After 7 d, laparotomy was again performed using ketamine, propofol, thiopental, or fentanyl anesthesia whose antioxidative properties are well known in oxidative stress in a rat liver model of obstructive jaundice. After 2 h, the rats were sacrificed. Renal tissue specimens were analyzed for catalase, superoxide dismutase and malondialdehyde enzymes activities. All values are expressed as the mean ± SD. P values less than 0.05 were considered statistically significant.

RESULTS: All animals survived without complications until the end of the study. Enlargement in the bile duct and obstructive jaundice were observed in all rats. Catalase was found to be significantly lower in the fentanyl group than in the ketamine (P = 0.039), propofol (P = 0.012), and thiopental (P = 0.001) groups. Superoxide dismutase activities were similar in all groups (P > 0.05). Malondialdehyde was found to be significantly lower in the ketamine group than in the propofol (P = 0.028), thiopental (P = 0.002) and fentanyl (P = 0.005) groups. Malondialdehyde was also lower in the fentanyl group than in the thiopental group (P = 0.001). The results showed that obstructive jaundice sensitizes renal tissue to damage under the different anesthetics.

CONCLUSION: Among the agents tested, ketamine and propofol generated the least amount of oxidative stres on renal tissues in this rat model of obstructive jaundice created by common bile duct ligation. The importance of free radical injury in renal tissue in obstructive jaundice under different intravenous anesthetics during hepatobiliary and liver transplant surgery should be considered for prevention of postoperative acute renal failure.

Keywords: Obstructive jaundice; Postoperative acute renal failure; Oxidative stress; Intravenous anesthetics; Renal tissue damage

Core tip: There is an increased incidence of postoperative acute renal failure in patients with obstructive jaundice. Recent studies suggested that the free oxygen radicals produced in obstructive jaundice may play a major role in the etiopathogenesis of acute renal failure. We evaluated the protective effects on kidney tissue of frequently used intravenous anesthetics, whose antioxidative properties are well known, in a rat model of obstructive jaundice. Among the agents tested, ketamine and propofol generated the least amount of oxidative stres on renal tissues in this rat model of obstructive jaundice created by common bile duct ligation.